Utilization Management Nurse Team Lead

Role Overview

The Utilization Management Nurse Team Lead ensures efficient, cost-effective, and high-quality delivery of utilization review service by supporting and training a staff of registered nurses. They oversee the management of medical cases worked by registered nurses and ensure customer satisfaction through the provision of cost-effective and high-quality utilization review service.

What You Will Do

Serve as a clinical and operational team lead for Utilization Management nurses, provide day-to-day guidance, mentorship, and clinical support, and train and develop utilization review staff.

Why It Might Be a Fit

This role requires a strong clinical background, excellent communication skills, and the ability to work in an independent and creative manner. The ideal candidate will be able to manage multiple projects and priorities, adapt to a high-paced and changing environment, and demonstrate a customer service-oriented approach.

Requirements

• 3 years Clinical experience
• 2 years of Utilization Review
• Current, active Compact State license in Nursing (RN)
• Proficient in Microsoft Office (Outlook, Word, Excel)
• Working knowledge of NCQA
• Ability to manage multiple projects and priorities
• Adaptive to high pace and changing environment
• Customer service oriented

Benefits

• 401K (4% Match, Immediate Vesting)
• Accident insurance
• Competitive salary
• Critical Illness Insurance
• Dental Insurance
• Employee Assistance Program
• Flexible Spending Account
• Health & Wellness Program
• Health Savings Account
• Life & AD&D Insurance
• Long Term Disability
• Medical Insurance
• Paid Time Off
• Pet Insurance
• Short Term Disability
• Vision Insurance